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the aspects of practice in nursing environments which affects the quality of caring. In his study, Ahmadi refers to the effects of workload and states that most Iranian nurses suffer from heavy workload and do not have the opportunity to consider patients’ various needs and provide holistic care.[26] Similarly, Olive introduces workload as a barrier to the formation of holistic care.[6] Management, another component of professional environment, includes various domains such as evaluation methods, orientation programs for staff and management approaches. The results of this study show that nursing management is inefficient and that the nurses in this study were dissatisfied with the style of management, and do not have any orientation programs. The above-mentioned issues play an important role in the formation of holistic care and, when suitable, can enhance the provision of this mode of caring by creating motivation in nurses and increasing their knowledge. Strindberg's study in Sweden confirms this fact and emphasizes the role of management in promoting holistic care.[1] Duffy and McEvoy, likewise, call attention to the importance of professional environment and its various effects on nurses’ performance; they consider a suitable environment as a prerequisite of holistic care.[10]Clinical environments’ lack of conformity with professional norms is another factor which makes nurses loose interest in professional and ethical values, and acts as a disincentive to providing holistic care.[28] The results show that most nurses have encountered this problem and experienced it on the first days of working. Various studies—e.g. Silva,[29] Abedi[30] and Valdez[31]—recognize the limited conformity of the clinical environment with professional norms as a big challenge which most novice nurses encounter. Many of the participants in the study referred to clinical environments’ poor conformity with professional and ethical norms as a deterrent to providing holistic care; they also stated that many of the novice nurses would follow their colleagues’ example and neglect patients and their needs. Henderson, likewise, points out in his study that clinical environments’ poor conformity with norms greatly contributes to novice nurses’ disregard for holistic care and encourages them to stick to the routine duties and ignore the patients’ various needs.[16]The findings of this study prove that motivational factors—input data, personality traits, and personal experiences—are influential in identifying patients’ various needs and generating holistic perceptions of the patient, which in turn encourage nurses to attend to patients’ diverse needs and provide holistic care. Personality traits play a major role in expanding relationship with patients, identifying their various needs and developing holistic perception on the part of nurses. Also, religiousness and morality can induce one to satisfy patients’ needs and provide holistic care, and in many cases overcome the defects in the educational and clinical systems. Obviously, one's behavior is decided by his/her personality traits; thus, a nurse's performance, behavior toward patients, and attempts at expanding relationship with them are decided by his/her personality traits.
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